Non-invasive brain stimulation combined with psychosocial intervention for depression: a systematic review and meta-analysis

Abstract

Objectives This review investigates the efficacy and safety of non-invasive brain stimulation (NIBS) combined with psychosocial intervention on depressive symptoms. Materials and methods We systematically searched five electronic databases from their inception to June 2021: PubMed, Embase, PsycINFO, Web of Science, and Medline. Randomized or non-randomized clinical trials in which NIBS plus psychosocial intervention was compared to control conditions in people with depressive symptoms were included. Results A total of 17 eligible studies with 660 participants were included. The meta-analysis results showed that NIBS combined with psychosocial therapy had a positive effect on moderate to severe depression ([SMD = − 0.46, 95%CI (− 0.90, − 0.02), I2 = 73%, p < .01]), but did not significantly improve minimal to mild depression ([SMD = − 0.12, 95%CI (− 0.42, 0.18), I2 = 0%, p = .63]). Compared with NIBS alone, the combination treatment had a significantly greater effect in alleviating depressive symptoms ([SMD = − 0.84, 95%CI (− 1.25, − 0.42), I2 = 0%, p = .93]). However, our results suggested that the pooled effect size of ameliorating depression of NIBS plus psychosocial intervention had no significant difference compared with the combination of sham NIBS [SMD = − 0.12, 95%CI (− 0.31, 0.07), I2 = 0%, p = .60] and psychosocial intervention alone [SMD = − 0.97, 95%CI (− 2.32, 0.38), I2 = 72%, p = .01]. Conclusion NIBS when combined with psychosocial intervention has a significant positive effect in alleviating moderately to severely depressive symptoms. Further well-designed studies of NIBS combined with psychosocial intervention on depression should be carried out to consolidate the conclusions and explore the in-depth underlying mechanism.

Novel Approaches for the Treatment of Post-Traumatic Stress Disorder: A Systematic Review of Non-Invasive Brain Stimulation Interventions and Insights from Clinical Trials

“…Under this scenario, psychotherapy could gain advantage from NIBS application in terms of enhancing its efficacy and promoting faster and more durable decrements in PTSD symptoms [ 109 , 110 ]. Also, NIBS could benefit from psychotherapy as well, since the neuronal modifications induced by psychotherapeutic interventions would foster the synaptic changes caused by neurostimulation, making them more likely to take place and longer-lasting over time.…”

The effects of a magic‐based intervention on self‐esteem, depressive symptoms, and quality of life among community‐dwelling older adults: a randomised controlled trial

“…17,18 Psychosocial interventions, which target psychological or social factors instead of biological factors, 19,20 aim to improve various aspects of wellbeing, such as physical, psychological, cognitive, behavioural, and social well-being. 21 These interventions have demonstrated effectiveness in boosting self-esteem, alleviating depressive symptoms, and enhancing QOL for older adults. 22,23 A systematic review and meta-analysis of 69 controlled studies found that psychosocial interventions, including skill training, group support, and social activities, improved positive mental health and QOL while reducing depressive symptoms in older adults without mental disorder diagnoses.…”

“…Psychosocial interventions, which target psychological or social factors instead of biological factors, 19,20 aim to improve various aspects of well‐being, such as physical, psychological, cognitive, behavioural, and social well‐being 21 . These interventions have demonstrated effectiveness in boosting self‐esteem, alleviating depressive symptoms, and enhancing QOL for older adults 22,23 .…”

High-frequency repetitive transcranial magnetic stimulation alleviates the cognitive side effects of electroconvulsive therapy in major depression

“…In addition, dietary capsaicin confers the prevention of depression via regulation of the monoamine transmitter by improving the gut microbiota dysbiosis (12)(13)(14). However, non-invasive brain stimulation (NIBS) is one of the fastest-growing fields in the treatment for major depression (15), and it refers to a set of techniques used to modulate brain activity using non-implantable methods, including electroconvulsive therapy and transcranial magnetic stimulation (TMS) (16,17).…”